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A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy

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An Erratum to this article was published on 20 November 2007

Abstract

Background

This study aimed to compare the oncologic results for local excision via transanal endoscopic microsurgery (TEM) and those for laparoscopic resection (LR) via total mesorectal excision in the treatment of T2 N0, G1-2 rectal cancer after neoadjuvant therapy with both treatments, incorporating a 5-year minimum follow-up period.

Methods

The study enrolled 70 patients whose malignancy was staged at admission as T2 N0, G1-2 rectal cancer located within 6 cm of the anal verge with a tumor diameter less than 3 cm. Of these patients, 35 were randomized to TEM and 35 to LR. The patients in both groups previously had undergone high-dose radiotherapy (5,040 cGy in 28 fractions over 5 weeks) combined with continuous infusion of 5-flurouracil (200 mg/m2/day).

Results

The median follow-up period was 84 months (range, 72–96 months). Two local recurrences (5.7%) were observed after TEM and 1 (2.8%) after LR. Distant metastases (2.8%) occurred in one case each after TEM and LR. The probability of survival for rectal cancer was 94% for TEM and 94% for LR.

Conclusions

The study shows similar results between the two treatments in terms of local recurrences, distant metastases, and probability of survival for rectal cancer.

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Acknowledgments

The authors are grateful to Professor Flavia Carle from the Department of Epidemiology and Statistics of the University “Politecnica delle Marche,” Ancona for her contribution.

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Correspondence to E. Lezoche.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00464-007-9714-x

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Lezoche, G., Baldarelli, M., Mario et al. A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy. Surg Endosc 22, 352–358 (2008). https://doi.org/10.1007/s00464-007-9596-y

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  • DOI: https://doi.org/10.1007/s00464-007-9596-y

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